[Inhalation injury of the lung]

Abstract

Because of the complex composition of smoke generated during fires and the possible combination of inhalation injury with other pulmonary complications of burns, the clinical course of inhalation injury is variable. Because clinical manifestations may be delayed several hours and furthermore are not specific, fiberoptic bronchoscopy is most appropriate in diagnosing pulmonary injury at the time of admission. Dominating pathological feature is a membraneous tracheobronchitis. Acute airway occlusion with sloughed bronchial mucosa, oedema formation and pulmonary infection are the most common complications. Treatment includes administration of oxygen, use of bronchodilators, and, when necessary, mechanical ventilation. Supplemental oxygen delivered at high concentrations will increase CO elimination and should be administered to all patients until the blood level of carboxyhaemoglobin has been measured.